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General NPI Number Information
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NPI Number | 1104217397
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Entity Type | Organization
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Legal Business Name | SOLID GROUND COUNSELING CENTER LLC
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Dates
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Enumeration Date | 02/10/2015
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Last Update Date | 10/14/2016
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Provider Practice Location Address
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Address Line | 110 N 3RD ST
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City | BURLINGTON
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State | KS
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Zip | 66839-1353
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Country | US
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Telephone | 620-364-1415
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Fax | 620-364-1915
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Provider Business Mailing Address
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Address Line | 110 N 3RD ST
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City | BURLINGTON
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State | KS
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Zip | 66839-1353
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Country | US
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Telephone | 620-364-1415
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Fax | 620-364-1915
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Authorized Official
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Title or Position | THERAPIST/OWNER
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Name | MS. KIM LEANNE BOWERS
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Credential | LCPC, LCAC
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Telephone | 620-364-1415
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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